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Operations Support - Claims (Rockville)

Operations Support - Claims (Rockville)

Fulcrum DigitalPune, Maharashtra, India
10 days ago
Job description

Who are we

Fulcrum Digital is an agile and next-generation digital accelerating company providing digital transformation and technology services right from ideation to implementation.

These services have applicability across a variety of Industry including banking & financial services insurance retail higher education food healthcare and manufacturing. Headquartered in the bustling city of New Jersey Fulcrum was rated among the fastest growing Software Companies in Inc 5000 Club and No. 7 Technology firm in New Jersey by NJ Biz.

Our team of business and technical consultants are spread across the US and other regions including the UK Portugal LATAM Australia and Finland where we have our operations.

The Role

  • Must have experience in insurance Domain Property & Casualty medical health Claims processing and Operations.
  • Create update and maintain operations / SOP documents and access systems on behalf of the Claims leadership group and provide the right data to them.
  • Need ability to operate effectively at all levels from managing front line employees to interacting with executives.
  • Demonstrate ability to identify and implement efficiencies within an operations environment.
  • Need ability to manage operational inventory to meet stated Service Level Agreements.
  • Ensure that all activity is properly documented within the appropriate Client system.
  • Communicate with Global Claims relationship managers to support their delivery and execution of the global claims strategy to assigned carriers and promote continued engagement.
  • Manage and process claims related to property damage personal injury and liability.
  • Investigate the validity of claims assess coverage and ensure accurate settlement outcomes.
  • Collaborate with adjusters legal teams and clients to resolve claims efficiently.
  • Review policy details with clients to ensure clear understanding and compliance.
  • Maintain accurate records of policies claims communications and necessary documentation.

Requirements

  • Good verbal and written communication skills.
  • Knowledge on how to use claims processing tools like File Handler
  • Must be able to communicate with onsite people.
  • Working knowledge of Medical health claims processing.
  • Experience in working for medical stop loss and healthcare industry for US Clients
  • Need ability to operate effectively at all levels from managing front line employees to interacting with executives
  • Demonstrate ability to identify and implement efficiencies within an operations environment
  • Need ability to manage operational inventory to meet stated Service Level Agreements
  • Ensure that all activity is properly documented within the appropriate Client system
  • Communicate with Global Claims relationship managers to support their delivery and execution of the global claims strategy to assigned carriers and promote continued engagement
  • Solutions Architect solution architect will need to help product owner on digital transformation, or business process automation or automation tools

    Education

    Key Skills

    Foreign Office,Analysis,Banking Operations,Corporate Finance,Manual Testing

    Employment Type : Full Time

    Experience : years

    Vacancy : 1

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    Operation • Pune, Maharashtra, India

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